Provider Demographics
NPI:1487529160
Name:BOUNCE BACK COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:BOUNCE BACK COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:435-862-6575
Mailing Address - Street 1:514 28 1/4 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-4961
Mailing Address - Country:US
Mailing Address - Phone:970-462-9589
Mailing Address - Fax:970-549-0049
Practice Address - Street 1:623 JET CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-6081
Practice Address - Country:US
Practice Address - Phone:970-462-9589
Practice Address - Fax:970-549-0049
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOUNCE BACK COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-10
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000236346Medicaid